Hi everyone. My cat is a 4 year old siamese/american shorthair mix. A few weeks ago, he stopped eating and started losing weight. We took him to the vet where they tested him for feline leukemia and it came back negative. They did a complete blood count and it all came back normal. They did an x-ray and found some gas in his intestines, indicating a blockage but the gas subsided after a few days. They tested him for FIP and foreign infection and it came back negative.
My vet sent his test results to a vet at U of M and she's not sure what's wrong with him. They did an ultrasound on his abdomen and now they think it's pancreatitis, which they are treating with antibiotics, IV fluids, and IV antibiotics but it's not having any effect. His abdomen is full of what they think is pancreatic fluid. He's very uncomfortable and he won't eat or drink.
They're going to continue treatment for a few more days but if he doesn't get better, they recommend putting him to sleep. We're out of ideas. Does anyone know of any similar cases?
Very sick cat - Emergency
A new opinion, immediately!
Ask your vet to consult with an internal med specialist right away, just because the vet at U of M doesn't know, doesn't mean another one won't!!
Pancreatitis can be partially diagnosed with bloodwork, but confirmation needs an fPLI sent to an outside lab, hopefully, they sent one?
After the first xray, was a barium xray series considered to locate any source of obstruction in the stomach, intestines, colon??
Was an analysis done on the fluid? (fluid aspirate) - the fluid MUST be analyzed in order to determine the type and potential source. If the fluid is severe, it must be tapped and removed (needle aspiration) to allow the cat to be comfortable and breathe comfortably.
Was chylothorax ruled out? (this is a bacterial infection usually originating in the intestines but can migrate nearly anywhere)
Was intestinal perforation ruled out? If the intestine happened to be perforated, this will release toxins into the bloodstream and abdomen, cause peritonitis or sepsis, and requires exploratory surgery to lavage the abdominal cavity and repair the intestine.
Was liver disease or bladder or gallbladder disease ruled out? (the latter two can rupture and cause fluid in the abdomen) - In some liver and kidney diseases, cysts can form and those cysts can rupture, leading to fluid, bacteria, etc. Masses on or around vital organs also need to be ruled out because fluid can form around them.
Was heart disease ruled out? (right-sided heart failure can cause fluid buildup)
Was protein abnormalities ruled out? (low protein can cause fluid buildup, like protein-losing-enteropathy)
Was hemorrhage ruled out? Only way to tell is aspiration of fluid, and testing for anemia, blood clotting problems, etc.
Was there any trauma, as in being outdoors and possibly hit by a car? Toxic ingestion? Poisoning? Accident in the home?
Emergency might employ a endoscopy that also allows a sample to be taken to determine cause of infection or inflammation. Exploratory surgery may also be an option, but this requires the cat to be a good anesthesia candidate, all hematology parameters must be a-ok, blood clotting abilities, and otherwise in good health to undergo surgery and recovery.
Is the vet certain the chemistry and other bloodwork was normal? You mentioned a CBC, but was a chemistry profile done as well?
I would ask your vet to consult with an internal medicine specialist or gastroenterologist immediately, either via online on VIN, or via a university specialist, or both! - the department specialty is important here! (it doesn't have to necessarily be U of M)
DO NOT GIVE UP! This may or may not be pancreatitis, it's possible that pancreatitis has developed due to another condition or worsening problem, but that problem needs to be identified. The fluid needs to be analyzed, the source needs to be found. First ask about a possible ultrasound-guided biopsy, then ask about endoscopy, or potential exploratory surgery, but either one would most likely need to be done before kitty's condition declines to the degree that surgery was not possible - remember clotting factor ability must be tested first!!
Please do not wait on this, if you have to, demand of your vet to consult a specialist on your behalf, TOMORROW.
Please update when you know more? Hang in there, don't give up, a specialist should be able to define where the fluid is coming from, hopefully based on the fluid aspirate. In the immediate sense, the IV's and antibiotics are helpful, but they may need to start a feeding tube to prevent hepatic lipidosis. Diagnosis is priority!
Ask your vet to consult with an internal med specialist right away, just because the vet at U of M doesn't know, doesn't mean another one won't!!
Pancreatitis can be partially diagnosed with bloodwork, but confirmation needs an fPLI sent to an outside lab, hopefully, they sent one?
After the first xray, was a barium xray series considered to locate any source of obstruction in the stomach, intestines, colon??
Was an analysis done on the fluid? (fluid aspirate) - the fluid MUST be analyzed in order to determine the type and potential source. If the fluid is severe, it must be tapped and removed (needle aspiration) to allow the cat to be comfortable and breathe comfortably.
Was chylothorax ruled out? (this is a bacterial infection usually originating in the intestines but can migrate nearly anywhere)
Was intestinal perforation ruled out? If the intestine happened to be perforated, this will release toxins into the bloodstream and abdomen, cause peritonitis or sepsis, and requires exploratory surgery to lavage the abdominal cavity and repair the intestine.
Was liver disease or bladder or gallbladder disease ruled out? (the latter two can rupture and cause fluid in the abdomen) - In some liver and kidney diseases, cysts can form and those cysts can rupture, leading to fluid, bacteria, etc. Masses on or around vital organs also need to be ruled out because fluid can form around them.
Was heart disease ruled out? (right-sided heart failure can cause fluid buildup)
Was protein abnormalities ruled out? (low protein can cause fluid buildup, like protein-losing-enteropathy)
Was hemorrhage ruled out? Only way to tell is aspiration of fluid, and testing for anemia, blood clotting problems, etc.
Was there any trauma, as in being outdoors and possibly hit by a car? Toxic ingestion? Poisoning? Accident in the home?
Emergency might employ a endoscopy that also allows a sample to be taken to determine cause of infection or inflammation. Exploratory surgery may also be an option, but this requires the cat to be a good anesthesia candidate, all hematology parameters must be a-ok, blood clotting abilities, and otherwise in good health to undergo surgery and recovery.
Is the vet certain the chemistry and other bloodwork was normal? You mentioned a CBC, but was a chemistry profile done as well?
I would ask your vet to consult with an internal medicine specialist or gastroenterologist immediately, either via online on VIN, or via a university specialist, or both! - the department specialty is important here! (it doesn't have to necessarily be U of M)
DO NOT GIVE UP! This may or may not be pancreatitis, it's possible that pancreatitis has developed due to another condition or worsening problem, but that problem needs to be identified. The fluid needs to be analyzed, the source needs to be found. First ask about a possible ultrasound-guided biopsy, then ask about endoscopy, or potential exploratory surgery, but either one would most likely need to be done before kitty's condition declines to the degree that surgery was not possible - remember clotting factor ability must be tested first!!
Please do not wait on this, if you have to, demand of your vet to consult a specialist on your behalf, TOMORROW.
Please update when you know more? Hang in there, don't give up, a specialist should be able to define where the fluid is coming from, hopefully based on the fluid aspirate. In the immediate sense, the IV's and antibiotics are helpful, but they may need to start a feeding tube to prevent hepatic lipidosis. Diagnosis is priority!
..........Traci
Re: Very sick cat - Emergency
Hoping you were able to get more answers and a second opinion! Praying for kitty's recovery.
Re: Very sick cat - Emergency
Thank you Traci for your help. I asked my vet all of your questions and he consulted a specialist. They tested the fluid in his abdomen and it turned out to be FIP. The first test was a false negative. Unfortunately he passed away Thursday night in his sleep.
Re: Very sick cat - Emergency
I am so very very sorry to learn this, my heart just breaks for your kitty and you.
For what it's worth, there are rarely false-negatives on FIP tests, and I've never seen one. Not only that, but testing for FIP is difficult in that they must be very specific PCR-titers, and they must be interpreted correctly. Other in-house labwork also has to be taken into account when attempting to diagnose FIP. There are certain markers and enzymes that would be tested specifically in addition to FIP titers. Even if the test result appears normal, when symptoms mimic FIP, it is wise to get another titer done for confirmation.
In light of that, it would not have changed the outcome. I am so broken-hearted for you, FIP is a horrible, incurable disease, and even less understood (at least in testing). I hope you can find some comfort in knowing you did everything you possibly could do to help your sweet little boy, and he knew that and knew just how very dedicated you were and just how much you loved him.
((((((HUGS))))))
For what it's worth, there are rarely false-negatives on FIP tests, and I've never seen one. Not only that, but testing for FIP is difficult in that they must be very specific PCR-titers, and they must be interpreted correctly. Other in-house labwork also has to be taken into account when attempting to diagnose FIP. There are certain markers and enzymes that would be tested specifically in addition to FIP titers. Even if the test result appears normal, when symptoms mimic FIP, it is wise to get another titer done for confirmation.
In light of that, it would not have changed the outcome. I am so broken-hearted for you, FIP is a horrible, incurable disease, and even less understood (at least in testing). I hope you can find some comfort in knowing you did everything you possibly could do to help your sweet little boy, and he knew that and knew just how very dedicated you were and just how much you loved him.
((((((HUGS))))))
..........Traci
Re: Very sick cat - Emergency
I'm so sorry for your loss.